Influence of organic chromium supplementation on the performance of beef calves undergoing weaning-related stress / Influência da suplementação com cromo orgânico no desempenho de bezerros de corte submetidos ao estresse da desmama

Dietary chromium supplementation before, during, and after weaning was conducted to evaluate the hypothesis that chromium supplementation could reduce weaning-induced cortisol release in beef calves. We examined the effects of chromium supplementation in 150 crossbred calves (male and female) between five and six months of age. The calves were randomly divided by sex and breed into two equal homogeneous groups (n=75). One group was used as the control, and the other experimental group received supplementation with 0.9mg of chromium carbon-amino-phospho-chelate per 100kg BW. The chromium supplement was mixed with mineral salt for the consumption of 0.1% of BW, and the supplement was administered via creep feeding 60 days before and 60 days after forced weaning. Calves were weighed, and their blood and urine samples were obtained at four time-points: T0 (60 days before weaning), T1 (at weaning), T2 (48 hours after weaning), and T3 (60 days after weaning). Blood samples were used to determine chromium, cortisol, total protein, and albumin concentrations, and urine samples were used to determine urinary creatinine and chromium levels. Cumulative weight gain was higher in calves supplemented with chromium before weaning and during the experiment (P<0.05). In addition, weaning-related stress caused an increase in chromium excretion in the urine, and chromium supplementation reduced stress, which resulted in lower cortisol and total protein levels during weaning.(AU)

O estudo foi realizado para avaliar a hipótese de que a suplementação dietética com cromo antes, durante e após a desmama possa diminuir a concentração de cortisol causado por este processo em bezerros de corte. Para tal, foram utilizados 150 bezerros mestiços, machos e fêmeas, entre cinco e seis meses de idade. Os animais foram divididos randomicamente por sexo e grupo genético em dois grupos homogêneos (n=75), um mantido como controle e outro suplementado com 0,9mg de carboaminofosfoquelato de cromo/100 kg PV misturado a um sal proteinado para ser consumido na base de 0,1% do PV via creep feeding, no decorrer de 60 dias antes e 60 dias após à desmama forçada. Os animais foram pesados e foram coletadas amostras sanguíneas e urinárias no M0 (60 dias antes da desmama), M1 (desmama), M2 (48 horas após a desmama) e M3 (60 dias após à desmama) para determinação de cromo, cortisol, proteína total e albumina no sangue e da concentração urinária de creatinina e cromo. O ganho acumulado de peso foi superior nos bezerros suplementados com cromo antes da desmama e no decorrer de todo o experimento (P<0,05). A suplementação com cromo reduziu os teores de cortisol e de proteína total durante a desmama. O estresse da desmama provocou aumento da excreção de cromo pela urina.(AU)

Adaptation and Validation of the Korean Version of the Urticaria Control Test and Its Correlation With Salivary Cortisone

PURPOSE: Frequent changes in chronic urticaria (CU) activity over time can cause psychological stress, which also serves as a trigger of CU. To measure the control status of CU, the Urticaria Control Test (UCT) was developed in Germany. This study aimed to investigate the validity, reliability and responsiveness to changes in CU for the Korean version of the UCT (K-UCT) and its relation with salivary cortisol and cortisone levels. METHODS: Linguistic adaptation of the UCT into Korean was conducted. A total of 96 CU patients were enrolled, and 80 of them completed the study. The K-UCT and other outcome scores for CU were measured and repeated after 4 weeks of treatment. Control status was classified by physicians into well-controlled, partly-controlled, and uncontrolled CU. Salivary cortisol and cortisone were measured by liquid chromatography-tandem mass spectrometry. RESULTS: Excellent internal consistency and intra-class reliability were obtained. Strong correlations between the K-UCT and disease severity, reflected in the Urticaria Activity Score (UAS)/global assessment of urticaria control by physicians/patient assessment of symptom severity/CU-specific quality of life were noted. K-UCT scores ≥12 were found to be optimal for determining well-controlled CU (sensitivity, 75.0%; specificity, 758%; area under the curve, 0.824). Perceived stress scale scores were significantly correlated with the UAS and the K-UCT. Salivary cortisone levels were significantly correlated with K-UCT (r = 0.308, P = 0.009) and differed significantly according to control status determined by a K-UCT ≥12. CONCLUSIONS: This study demonstrated that the K-UCT can be a valid instrument with which to gauge CU control status in Korean patients. Further studies are needed to validate salivary cortisone as a biomarker for CU control.

11ß-hydroxysteroid dehydrogenase type-II activity is affected by grapefruit juice and intense muscular work

ABSTRACT Objective The enzymatic activity of 11β-hydroxysteroid dehydrogenase-2 (11β-HSD2) is key to protecting mineral corticoid receptors from cortisol and has been implicated in blood pressure regulation. Grapefruit juice (GFJ) and acidity are thought to inhibit this enzyme in vitro. This study examines the effect of GFJ and intense exercise on 11β-HSD2 enzyme activity in vivo. Subjects and methods Eighteen subjects ingested GFJ or apple juice (CON) on separate days prior to reporting to the laboratory in a randomized order. Saliva (Sal) samples were obtained at baseline, 15 and 45 minutes post-treadmill stress test; Sal cortisone (E) and cortisol (F) levels were determined, and the Sal cortisone:cortisol (E:F) ratio was used as an index of 11β-HSD2 enzyme activity at rest and after intense muscular work. Results GFJ treatment decreased baseline 11β-HSD2 enzyme activity (44%) and Sal-E (28%) compared to CON (both, p < 0.05). Sal-E (r = 0.61, p < 0.05) and Sal-F (r = 0.66, p < 0.05) were correlated with diastolic blood pressure (DBP) in GFJ-treated individuals. Treadmill stress significantly increased Sal-E and Sal-F but did not alter 11β-HSD2 enzyme activity regardless of treatment. When treatments were examined separately, CON 11β-HSD2 enzyme activity decreased by 36% (p < 0.05) from baseline to 15 post-treadmill exercise. Conclusion Our findings suggest that GFJ and intense muscular work decrease 11β-HSD-2 activity independently, and no additive effect was noted. The association between DBP and the levels of Sal-F and Sal-E during the GFJ trial should be interpreted cautiously and warrants further investigation.

Effects of Cellular 11β-hydroxysteroid Dehydrogenase 1 on LPS-induced Inflammatory Responses in Synovial Cell Line, SW982

11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) catalyzes the conversion of inactive cortisone into active cortisol, which has pleiotropic roles in various biological conditions, such as immunological and metabolic homeostasis. Cortisol is mainly produced in the adrenal gland, but can be locally regenerated in the liver, fat, and muscle. Its diverse actions are primarily mediated by binding to the glucocorticoid receptor. SW982, a human synovial cell line, expresses 11β-HSD type 1, but not type 2, that catalyzes the conversion of cortisone to cortisol. In this study, therefore, we investigated the control of lipopolysaccharide (LPS)-induced inflammatory responses by prereceptor regulation-mediated maintenance of cortisol levels. Preliminarily, cell seeding density and incubation period were optimized for analyzing the catalytic activity of SW982. Additionally, cellular 11β-HSD1 still remained active irrespective of monolayer or spheroid culture conditions. Inflammatory stimulants, such as interleukin (IL)-1β, tumor necrosis factor (TNF)α, and LPS, did not affect the catalytic activity of 11β-HSD1, although a high dose of LPS significantly decreased its activity. Additionally, autocrine effects of cortisol on inflammatory responses were investigated in LPS-stimulated SW982 cells. LPS upregulated pro-inflammatory cytokines, including IL-6 and IL-1β, in SW982 cells, while cortisol production, catalyzed by cellular 11β-HSD1, downregulated LPS-stimulated cytokines. Furthermore, suppression of NFκB activation-mediated pro-inflammatory responses by cortisol was revealed. In conclusion, the activity of cellular 11β-HSD1 was closely correlated with suppression of LPS-induced inflammation. Therefore, these results partly support the notion that prereceptor regulation of locally regenerated cortisol could be taken into consideration for treatment of inflammation-associated diseases, including arthritis.

Effects of Music Therapy on Subjective Stress Response, Salivary Cortisol, and Fatigue for Intensive Care Nurses

BACKGROUND: The purpose of this study was to verify the effects of music therapy on subjective stress response, salivary cortisol and fatigue for nurses working in intensive care unit (ICU). METHODS: This study employed non-equivalent control group pretest–posttest design on quasi experimental basis. Subjects were 52 nurses (26 experimental and control group respectively) who have been working at ICU of Gil Hospital in Incheon, Korea. Data were collected from August 4 to October 6, 2014. Experimental group have listened to their 4-7 favorite musics individually once for 30 minutes after day-work. RESULTS: In experimental group, subjective stress response (t=5.02, P<0.001), salivary cortisol (t=2.08, P=0.042), and fatigue (t=5.66, P<0.001) have decreased significantly comparing to the control group. CONCLUSIONS: This study has confirmed especially through objective physiological index of salivary cortisol that listening the favorite music for nurses in ICU was an effective and objective managerial measure to resolve their job stress and fatigue.

Determination of cortisol and cortisone in human saliva by a liquid chromatography-tandem mass spectrometry method / Determinação de cortisol e cortisona na saliva por método baseado em cromatografia líquida e espectrometria de massas em tandem

Objective Salivary cortisol measurement plays an important role in the evaluation of adrenal function. Its high correlation with free serum cortisol, the easy of sampling and the limited presence of interfering steroids, generated multiple recent studies of its application, in special in the screening of adrenal hyperfunction. In this paper we present our experience in the development of a high pressure liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method for salivary cortisol and cortisone measurement. Materials and methods For this study we used 181 saliva samples from our routine diagnostic laboratory. The HPLC-MS/MS method was based on a Waters Quattro Premier tandem mass spectrometer with an electrospray probe. After derivatization with hydroxylamine transitions monitored included cortisol and cortisone. An in-house radioimmunoassay (RIA) was used for salivary cortisol results comparison. Results Functional sensitivity was 24 ng/dL for cortisol and linearity from 24 to 1929 ng/dL. Saliva cortisol values obtained in the 181 samples presented a median of 52 ng/dL with 5‐95% percentile of 24 and 374 ng/dL. With the RIA the results were 86, 25 and 436 ng/dL, respectively, with values for RIA being significantly higher (P<0.0001) and high correlation (r=0.8312, P<0.0001). Cortisone measured in 159 samples showed a median of 278 ng/dL, with 5‐95% percentile of 100 and 1,133 ng/dL. Correlation with cortisol values was significant (r=0.820, P<0.0001). Conclusion We conclude that the HPLC-MS/MS method compares favorably with the RIA for salivary cortisol measurement, with the additional possibility of concomitant cortisone measurement and the evaluation of 11βHSD2 activity. .

Objetivo A dosagem de cortisol salivar é uma metodologia que vem tendo crescente aceitação no estudo da função adrenocortical. Sua alta correlação com a fração livre sérica, facilidade de coleta e presença limitada de interferentes têm originado múltiplas publicações, em especial no screening de pacientes suspeitos de hiperfunção. Neste trabalho apresentamos nossa experiência no desenvolvimento de metodologia baseada em cromatografia líquida e espectrometria de massas (HPLC-MS/MS) para a medida de cortisol e cortisona salivares. Materiais e métodos Para este estudo utilizamos 181 amostras de saliva de nossa rotina diagnóstica. A metodologia de HPLC-MS/MS baseou-se num espectrômetro de massas Waters Quattro Premier. Após derivatização com hidroxilamina, as transições monitoradas incluíram cortisol e cortisona. Um radioimunoensaio (RIE) in house foi empregado para comparação. Resultados A sensibilidade funcional para cortisol foi de 24 ng/dL, com linearidade entre 24 e 1,929 ng/dL. Os valores de cortisol obtidos nas 181 amostras apresentaram mediana de 52 ng/dL, com percentis 5‐95% de 24 e 374 ng/dL. Com o RIE, os resultados foram 86, 25 e 436 ng/L, respectivamente, com os valores obtidos no RIE significativamente mais elevados (P<0,0001), e alta correlação (r=0,8312, P<0,0001). Cortisona, medida em 159 amostras, mostrou mediana de 278 ng/dL, com percentis 5‐95% entre 100 e 1.133 ng/dL. A correlação com os valores de cortisol foi significativa (r=0,820, P<0,0001). Conclusão Concluímos que o método baseado em HPLC-MS/MS compara-se favoravelmente com o RIE para a medida de cortisol salivar, com a possibilidade adicional da medida concomitante de cortisona e avaliação da atividade da enzima 11βHSD2. .

Mineralocorticoid replacement during infancy for salt wasting congenital adrenal hyperplasia due to 21-hydroxylase deficiency

OBJECTIVE: The protocols for glucocorticoid replacement in children with salt wasting 21-hydroxylase deficiency are well established; however, the current recommendation for mineralocorticoid replacement is general and suggests individualized dose adjustments. This study aims to retrospectively review the 9-∝-fludrocortisone dose regimen in salt wasting 21-hydroxylase deficient children who have been adequately treated during infancy. METHODS: Twenty-three salt wasting 21-hydroxylase deficient patients with good anthropometric and hormonal control were followed in our center since diagnosis. The assessments of cortisone acetate and 9-∝-fludrocortisone doses, anthropometric parameters, and biochemical and hormonal levels were rigorously evaluated in pre-determined intervals from diagnosis to two years of age. RESULTS: The 9-∝-fludrocortisone doses decreased over time during the first and second years of life; the median fludrocortisone doses were 200 µg at 0-6 months, 150 µg at 7-18 months and 125 µg at 19-24 months. The cortisone acetate dose per square meter was stable during follow-up (median = 16.8 mg/m²/day). The serum sodium, potassium and plasma rennin activity levels during treatment were normal, except in the first month of life, when periodic 9-∝-fludrocortisone dose adjustments were made. CONCLUSIONS: The mineralocorticoid needs of salt wasting 21-hydroxylase deficient patients are greater during early infancy and progressively decrease during the first two years of life, which confirms that a partial aldosterone resistance exists during this time. Our study proposes a safety regiment for mineralocorticoid replacement during this critical developmental period.

Pharmacogenetics of glucocorticoid replacement could optimize the treatment of congenital adrenal hyperplasia due to 21-hydroxylase deficiency

INTRODUCTION: 21-hydroxylase deficiency is an autosomal recessive disorder that causes glucocorticoid deficiency and increased androgen production. Treatment is based on glucocorticoid replacement; however, interindividual variability in the glucocorticoid dose required to achieve adequate hormonal control has been observed. OBJECTIVE: The present study aimed to evaluate the association between polymorphic variants involved inglucocorticoid action and/or metabolism and the mean daily glucocorticoid dose in 21-hydroxylase deficiency patients. METHODS: We evaluated 53 patients with classical forms of 21-hydroxylase deficiency who were receiving cortisone acetate. All patients were between four and six years of age and had normal androgen levels. RESULTS: The P450 oxidoreductase A503V, HSD11B1 rs12086634, and CYP3A7*1C variants were found in 19 percent, 11.3 percent and 3.8 percent of the patients, respectively. The mean ± SD glucocorticoid dose in patients with the CYP3A7*1C and wild-type alleles was 13.9 ± 0.8 and 19.5 ± 3.2 mg/m²/d, respectively. We did not identify an association between the P450 oxidoreductase or HSD11B1 allelic variants and the mean glucocorticoid dose. CONCLUSION: Patients carrying the CYP3A7*1C variant required a significantly lower mean glucocorticoid dose. Indeed, the CYP3A7*1C allele accounted for 20 percent of the variability in the cortisone acetate dose. The analysis of genes involved in glucocorticoid metabolism may be useful in the optimization of treatment of 21-hydroxylase deficiency.

A randomized, double-blind, placebo-controlled study on the safety and efficacy of 0.025% capsaicin (Capsicum annuum var. longum) cream against 1% hydrocortisone cream as an anti-inflammatory and anti-pruritic preparation for mosquito bites

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-valueCONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.

Lichen planus in Hunan: 124 patients / 中南大学学报(医学版)

OBJECTIVE@#To determine the clinical feature of lichen planus in Hunan, and to provide references for correct diagnosis and treatment.@*METHODS@#The clinical data from 124 outpatients with lichen planus attending Dermatology Department of Xiangya Hospital, Central South University from January 2000 to April 2008 were analysed retrospectively, including data on sex, age of visit or onset, course of disease, clinical manifestation, histopathology, and so on.@*RESULTS@#In these 124 patients, male to female ratio was 1:1. Most patients were in 30-60 age group when they first visited the Out-patient Department. There were 2 onset peaks, one in 14-29 age group and the other in 40-60 age group. Most (35.5%) of the lesions were chronic localized subtypes. The limbs were the most common site to be involved, and they were also the most prevalent site for onset of lichen planus(74 cases, 59.7% ). The second common site was the trunk (29 cases, 23.4%). Fifteen patients (12.1%) had genitalia lesions, and 9 (7.3%) accompanied with oral mucosal involvement. Most of the eruptions were half-distributed (44.3%), 64 patients (51.6%) had pruritus,which ranged from mild irritation to severe intolerable itching, 56 (45.2%) had no subjective symptoms, 4 (3.2%) had spontaneous pain or tenderness, and 2 had positive family history of lichen planus. The diagnostic accordance rate was 50.8%.@*CONCLUSION@#Some characteristics exist in sex, age, and clinical manifestation of lichen planus in Hunan province. Systemic and/or local treatment should be taken according to the lesion morphology, localization and subtypes of lichen planus.

Obturator Internus Myofascial Pain: A Cause of Undiagnosed Chronic Pelvic Pain Syndrome: Case reports

Chronic pelvic pain is difficult to diagnose and usually has a poor outcome. However, if it was identified early it might have a better prognosis. We treated three patients whose trigger points in obturator internus were diagnosed as origin of myofascial pain. The first patient complained of coccygodynia with pain that radiated up his left leg when walking. The second patient had coccygeal pain that radiated to the left thigh area. The last patient was troubled with coccygeal and pelvic pain at anytime. In all of the cases MRI studies of the lumbar spine and pelvis were unrevealing. Electrodiagnostic studies were normal. The impression was that the patients had the myofascial pain syndrome, therefore injections with local anesthetics and cortisone at the myofascial pain originated in obturator internus. Although each of the patients had different symptoms, they all had a good response to treatment.

Immuno-modulation of cortisone-treated albino rats by thymoquinone

Thymoquinone is the active principle isolated from Nigella sativa seeds. It has shown potent anti-inflammatory effects and it has beneficial immunontodulatory properties. Although, cortisone has anti-inflammatory effects but it is one of the strongest known endogenous suppressors of the immune system. Cortisone increased chemotaxis of the white cells towards the Phosphate Buffer Saline [PBS] if it was injected intraperitonealy before thymoquinone while lead to a decrease if it was injected after thymoquinone. In contrast, the i.p injection of thymoquinone lead to a decrease if it was injected after cortisone while lead to increase if it was injected before cortisone. The i.p injection of cortisone and thymoquinone together didn't make observed changes. On the other hand, the chemotaxis of the white cells towards the antigen was increased at the 3[rd] week if cortisone was injected before thymoquinone and at the 4[th] week if it was injected after thymoquinone. While it was decreased slightly at the 5[th] week if cortisone and thymoquinone were injected together. The chemokinesis of white cells towards the PBS was decreased up to the end of experiniental time if cortisone was injected before thymoquinone while increased at the 5[th] week if it was injected after thymoquinone. It was decreased sharply at the 2[nd] week if cortisone and thymoquinone were injected together. On the other hand, the chemokinesis of white cells toward the antigen was decreased at the 7[th] week if cortisone was injected before thymoquinone and at the 8[th] week if it was injected after thymoquinone. Also, it was decreased sharply at the 2[nd] week if cortisone and thymoquinone were injected together. The results showed marked increase in percentage of Plaque Forming Cell [PFC] and Rosette Forming Cell [RFC], decrease in the agglutinating antibodies if cortisone was injected before or after thymoquinone while there was no marked change if they injected together, decrease in the total immunoglobulin level if cortisone was injected before or after thymoquinone while it was increased if cortisone and thymoquinone were injected together. It was clear that thymoquinone had an immune-modulatory effect on the immune-suppressive effect of cortisone and results showed that injection of thymoquinone with cortisone at the same time lead to higher effect than injecting it after or before cortisone

Regiones polimórficas del gen 11ß-hidroxiesteroide deshidrogenasa tipo 1 (11ßHSD1) en hipertensión arterial esencial: Posible rol etiopatogénico / Possible pathogenetic role of 11ß-hydroxysteroid dehydrogenase type 1 (11ßHSD1) gene polymorphisms in arterial hypertension

Background: Cortisol has been implicated in hypertension and lately reported to be regulated at the pre-receptor level by the 11ßHSD1 enzyme, which converts cortisone (E) to cortisol (F). Over expression ofthis enzyme in adipose tissue could determine an increase in available cortisol that interacts with the mineralocorticoid receptor (MR) in renal, brain and heart tissue, leading to similar hypertensive effects as in 11ßHSD2 impaired patients. Severa! polymorphisms have been reported in HSDl IB 1 gene (CAI5, CAI9 and InsA83557), which could modify HSDl IB 1 gene expression or activity. Aun: To determine the distribution and prevalence of CAI5, CAI9 and InsA83557 in the HSDl IBl gene, and to correlate these results with biochemical parameters in cortisol/ ACTH (HPA) and renin-angiotensin-aldosterone (RAA) axis in patients with essential hypertension (EH). Patients and Methods: We studied 113 EHpatients (76 non-obese and 37 obese, with a body mass índex >30 kg/m²) and 30 normotensive adults (NT). In each patient, we measured serum levéis of E E, serum aldosterone (SA), plasma renin activity (PRA), adrenocorticotrophic hormone (ACTH), the urinary free cortisol/creatinine (UFF/Cr), F/ACTH and SA/PRA ratios. Each polymorphism was studied by PCR and 8 percent polyacrylamide gel electrophoresis. Statistical associations were evaluated by Pearson correlations and the genetic equilibñum by the Hardy-Weinberg (H-W) equation. Results: We found all three polymorphisms in the EH and the NT group, both in genetic equilibñum. In obese essential hypertensives, the CAI5polymorphism showed association with SA/PRA ratio (r =0.189, p =0.012) and F/ACTH (r =0.301, p 0.048); CA19 also showed correlation with F/ACTH in obese EH (r = 0.220, p 0.009). The InsA83557polymorphism correlated with UFF/Cr in both EH (r =0.206; p =0.03), and in obese EH (r =0.354; p =0.05). Conclusions: The CAI5 and CAI9 polymorphism correlated with changes in biochemical parameters...

Drugs and nonsyndromic orofacial cleft: an update

Nonsyndromic orofacial cleft (OFC) derives from an embryopathy with failure of the nasal processes and/or fusion of the palatal shelves. This severe birth defect is one of the most common malformations among live births. Human cleft is composed of two separate entities: cleft of the lip with or without palate (CL±P) and cleft palate only (CPO). Both have a genetic origin, whereas environmental factors contribute to these congenital malformations. In this review we analyze the role of drugs related to the onset of cleft. The data were obtained from (i) epidemiologic studies (ii) animal models and (iii) human genetic investigations. These studies have demonstrated a relation between certain drugs (steroids and anticonvulsants) taken during pregnancy and a higher risk of generating offspring with OFC whereas no clear relation has been demonstrated between aspirin and OFC.

Avaliação da neurólise ulnar na neuropatia hansênica / Assessment of ulnar neurolysis in leprous neuropathy

Os autores avaliam os resultados de 35 procedimentos de descompressão cirúrgica do nervo ulnar realizados em 28 pacientes hansênicos. Os parâmetros utilizados incluíram a escala analógica visual, a escala comportamental, a avaliação da força muscular, a estesiometria e a avaliação do efeito do procedimento no que tange à diminuição da corticoterapia no pós-operatório. Observou-se resolução imediata da dor após a realização da cirurgia, melhora da força muscular em metade dos pacientes, melhora da sensibilidade em metade dos pacientes. A diminuição da dosagem da prednisona após a cirurgia foi constante e significativa após a operação.

In this study, the authors assess the results of 35 surgical ulnar nerve decompression procedures performed on 28 leprous patients. The parameters employed included the visual analogue scale, the behavioral scale, the muscle strength evaluation, the esthesiometry and the evaluation of the effect of the procedure on decreasing postoperative corticoid therapy doses. Early resolution of pain was seen after surgery, muscle strength increased in half of the patients, sensitivity increased in half of the patients, with ongoing and significant decrease of prednisone doses after surgery.

Histological study on the effect of thymoquinone -an immunomodulator- on duodenum and superior mesenteric lymph nodes of cortisone treated rats

Thymoquinone [TQ] was demonstrated as the major active component of Nigella sativa seed oil. It was reported that thymoquinone has an anti-inflammatory and immune-stimulatory effects. On the other hand, cortisone is one of the steroid hormones that used as an anti-inflammatory and immune-suppressor drug. In the present study, the effects of both thymoquinone and cortisone were studied on the histological structure of both duodenum and superior mesenteric lymph nodes of rats. It was noticed that there was an increase of the duodenum mucosal mucus-secreting cells and some nuclear changes in the nuclei of the Brunner's gland cells. There was an increase in number of macrophages, plasma cells and lymphocytes in the superior mesenteric lymph nodes. These findings were discussed according the anti-inflammatory and the immunestimulatory effects of thymoquinone as a point of view, and the anti-inflammatory and immune-suppressing effects of cortisone on another point of view. It was concluded that thymoquinone has an anti-inflammatory and immune sthnulatory effects on rat duodenum and superior mesenteric lymph nodes. However, more investigations are still in need to recommend the replacement of this natural ingredient instead of cortisone with its side effects

Value of urinary free cortisol/cortisone in assessing the activity of 11-beta-hydroxysteroid dehydrogenase in obese children: optimization of high performance liquid chromatography

Increased secretion of glucocorticoids is associated with obesity and cortisol secretion is increased in subjects with idiopathic obesity, especially of central distribution. Intercon-version of active cortisol with inactive cortisone is catalysed by the isozymes of 11 beta -HSD activities in different tissues can be assessed by ratio of urinary free cort isol to cortisone. The present study was carried out to evaluate the free cortisol/cortisone ratio in urine of obese children and adolescents to clarify the role of 11 beta-HSD in the pathogenesis of exogenous obesity. Thirty obese children were included in the present study; they were recruited from those attending Diabetic Endocrine Metabolic Pediatric Unit [DEMPU], Children Hospital, Cairo University, for assessment of obesity. Ten apparently healthy, non obese children matched in age and sex, were also included as controls. Urinary free cortisol [UFF] was measured by radio immune assay [RIA] and High performance liquid chromatography [HPLC] while urinary free cortisone [UFE] was measured by HPLC. The obtained results showed higher ratio of UFF/UFE in obese children suggesting that cortisol metabolism may be enhanced in children with higher body fat. This finding is supported by the positive correlation encountered between UFF and both BMI and fat%, which can be attributed to a higher activity of 11 beta-HSD-1 expressed in both subcutaneous and visceral fat with increased reactivation of cortisone to cortisol. This highlights the value of the UFF/UFE in demonstrating 11 beta-HSD activity more than measuring UFF or UFE alone. Finally, HPLC method under adopted conditions was found to be rapid, reliable and specific for measurement of both UFF and UFE

[ case of spontaneous pregnancy with Sheehan's syndrome]

Pregnancy in Sheehan syndrome is rare. Pituitary necrosis is sometimes incomplete and some remaining gonadotropic cells may induce ovulations. We report the case of a patient who presented with Sheehan syndrome and received cortisone and thyroxin substitutive therapy but no estrogen-progestogen treatment. One year later, the patient presented with a spontaneous pregnancy which was carried out until term. She delivered a healthy new born who was not breast-fed

Diagnosis and treatment of postoperative intervertebral infectio / 中南大学学报(医学版)

OBJECTIVE@#To retrospectively explore the diagnosis and treatment of postoperative lumbar intervertebral disc infection.@*METHODS@#Twelve patients who suffered from postoperative lumbar intervertebral disc infection between April 1995 and September 2004 were confirmed doubtlessly by the diagnosis. They were treated with early immobilization combined with early and sufficient antibiotics and adequate corticosteroid. Patients with severe symptoms were managed by percutaneous puncture and washing discectomy such as rising temperature and perivertebral muscle spasm besides nostalgia, and early debridement of all necrotic tissue was done.@*RESULTS@#Six were healed by non-operation and operation in the other 6. All had gotten locomotion with corset after the operation for 6-8 weeks and were followed-up from 6 months to 3 years. They have achieved excellent outcomes.@*CONCLUSION@#When a postoperative disc space infection occurs, early diagnosis and treatment should be undertaken to achieve excellent outcomes.